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1. Incorporating Radio Frequency Identification Technology Into the Health Care Sector October 22, 2004 Joi Crayton
Industry Brief RFID Technology Overview Overview This TKG industry brief provides an overview of the components, current issues and features of a wireless technology-Radio Frequency Identification (RFID). Current healthcare specific RFID applications and wireless vendor applications in trial phases are also highlighted. RFID Primer RFID is identification technology that helps to automate and computerize data capture. Initially developed in the 1970s, it uses radio waves to automatically identify people or objects. It had not been a popular technology until now because it had been too expensive and too limited to use in commercial applications. An RFID system uses distinct components to capture object information. It has a scanning antenna that scans for radio waves. There is a transceiver to interpret data, a reader to transmit and receive radio frequencies, and a transponder (radio frequency identification tag) that is attached to the object that is being identified. RFID and Bar Coding RFID can be referred to as an extension to bar coding. The objectives of bar coding and RFID are the same, but the bar coding methodologies for gathering data have their vulnerabilities and inefficiencies. The main vulnerability with bar coding is that line of sight scanning is required. Although bar coding labels may be less expensive, with RFID there is no need for anyone to manually scan each object because the components of the RFID system complete this task on their own. RFID tags store up to two kilobytes of data (depending on the vendor), whereas bar code labels can only store limited information about an object. RFID tags are also more durable than bar coding tags. RFID tags can endure x-rays and heated sterilization of medical items. Unlike bar code labels, RFID tags cannot be damaged and are not affected when dirty. RFID tags are read at a 100-1,000 tags per second rate, which is supremely faster than manual scanning of bar codes. As a result of the speed of RFID data gathering and the memory available for storage, more information can be gathered from an RFID tag than a bar-code label. Also long and short-range tag reading is available with RFID tags, but through bar coding, the code must be manually scanned within inches of the object. How does RFID work? Initially, the RFID system antenna scans its radio wave range for data transmissions. Once it receives a detection of radio waves, the transceiver uses a decoder to interpret the radio waves into data. Next, the reader reads the data from the INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 1
radio frequency identification tags and writes them to a microchip attached to the antenna for processing. All components of the RFID system must be on the same frequency in order to communicate. Component Attributes RFID readers come in large and small sizes. The larger sized readers are stationary and are ideal for reading objects related to supply chain management. The smaller size readers are portable and can be used for reading objects from inside other equipment. The RFID transponder (RFID tag) can be attached to any type of object. RFID tags usually hold about two kilobytes of memory (depending on the vendor) and are distinguished by different frequencies and reading abilities. RFID tags have low, high, and ultra high frequencies. RFID Tags Low frequency tags work along 120kHz – 140 kHz radio frequencies. The advantages of using a low frequency tag is that they are less expensive than the other tag types and use less power. High frequency tags work along 13.56 MHz radio frequencies. Ultra-high frequency tags work along 850-900 MHz. The advantages of using high and ultra-high frequency tags are that they are better at penetrating metallic substances, have better range than the lower frequency tags, and transfer data faster. The disadvantages of using ultra-high and high frequency tags are that they use more power, require a clear path between the tag and the reader, and are less likely to pass through non-metallic materials. In addition to the low, high, and ultra-high tags, there are three other types of RFID tags: active, semi-passive, and passive. Active RFID tags require a battery that runs microchip circuitry for radio wave transmissions, have read/write capabilities, and have longer read ranges. Passive RFID tags do not require a battery and cannot be modified. Semi-Passive tags use a battery to run, but depend on power from the reader to transmit information. Active and Semi-Passive tags are also useful for tracking high- value goods that need to be scanned over long ranges. Comparisons Between Active and Passive Frequency Tags (by Smart Code Corp) Attribute Active Tags Passive Tags Power Source Battery Power from Reader Weight 120 - 320 6-54 grams grams Read Ranges 100 feet or Less than 20 more feet Capabilities Read/Write Read Only Operational 5-10 Year Unlimited Life Memory 2 MB Up to 16 kilobytes Cost $100 $.40 - $10 INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 2
Issues The main issues concerning RFID systems are security and privacy, system costs, and compliance with current RFID wireless technology standards. Common Problems A reader collision is a common RFID problem that occurs when the signal from one reader can interfere with the signal from another where coverage overlaps. A prevention method for this is to make sure all readers are instructed to read at different times, otherwise known as Time Division Multiple Access (TDMA). Another commonly encountered problem is called tag collision, which is when more than one chip reflects back a signal at the same time and confuses the tag reader. Since RFID active tags require batteries, tag battery wear is another issue. This is an important problem because if batteries wear down, the system could be disrupted. System disruption can also be caused by bottlenecks in a certain frequency wavelength. RFID tags are also difficult to remove and often have trouble functioning correctly if exposed to water and metals. RFID tags have trouble with water and metals because radio waves bounce off metal and are absorbed by water at ultra-high frequencies. Costs The costs of an RFID system have always been an issue. Recent technology advances have reduced the cost of the system to a more competitive range. RFID readers usually cost around $1,000 - $2,000 and the RFID tags costs are presented below. Comparisons of Costs of RFID Frequency Tags (Cost per tag when purchased in bulk) Frequency Range Cost Low (120 – 140 kHz) $3 - $10 High (13.56 MHz) $.50 - $5.00 Ultra-High (868 – 956 MHz) $.75 and up Security and Privacy Preserving privacy is a main concern of anyone that is deciding whether or not to use an RFID system. One of the risks associated with using an RFID system is tags could be read by unauthorized readers, which could result in communications between the reader and tag being privately monitored. This could lead to other information leaks caused by individuals attempting to hack into the system. If hackers were successful they might be able to track or obtain personal information or a person’s whereabouts. Information leaks could be caused by someone illegally using an RFID reader to scan unauthorized information from RFID tags that they come in contact with. Solutions There are a few solutions to security or privacy issues caused by information leaks in an RFID system. Password or pin protection could be enforced. By using password or pin protection, passwords could be assigned by the tag purchaser so that tags could only be read with the owner’s permission. Also a Zombie RFID tag has been INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 3
created to keep individuals from tracking someone or some object after it has left a certain area. The Zombie tag can be temporarily or completely deactivated when it leaves a certain area. The tag has a unique serial number that could be erased, only leaving the prefix so that the tag purchaser maintains a record of the tag’s existence. A third solution for security issues is using signal encryption. Currently 8-bit encryption is available, but is not difficult to get around. As a result, some RFID chips now contain contact-less identification systems with an encryption algorithm that provides high security for information on the RFID chip. Similarly, code encryption could be used to combat information leaks. The encryption process uses an RCC method with a third code that combines the other two using encryption. This third code cannot be copied keeping an unauthorized individual from illegally obtaining tag information. There are also Blocker Tags (by RSA Security) that disrupt the transmission of information to scanning devices and prevent the illegal collection of data. Reassurance Research and predictions for RFID by Pete Abell, an RFID consultant at Boston- based EPCGroup, reveal that any shopper who brought their own RFID reader into a store would likely be detected. The research also reported that eventually RFID tags on products would be programmed to respond only to authorized readers. The American Hospital Association (AHA) has enforced guidelines for a tamperproof RFID product that minimizes the risk of lost or transferred data. There is also an RFID Bill of Rights that states that users and purchasers of RFID systems have the following rights based on the Code of Fair Information Practices: To know if a product contains an RFID tag; To have embedded tags destroyed; removed, deactivated once a product is purchased; First class RFID alternatives consumers should not lose their rights if they decide to opt-out-of RFID; and To know what kind of information is stored in RFID tags. Research and guidelines similar to these should help ease concerns of new and future RFID system users. Standards There are certain standards that the RFID system must comply with in order to be ethically sound. An RFID system must comply with standards for very specific applications of the International Organization for Standardization (ISO). The Administrative Simplification provisions for the Health Insurance Portability and Accountability Act of 1996 (HIPAA) must ensure that RFID and other wireless technologies establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. HIPAA also addresses maintaining the security and privacy of health data. The Joint Commission on Accreditation of Health Care Organizations (JCAHO) has guidelines for patient identification that must be adhered to in order to respect the privacy of hospital patients. Healthcare uses for RFID RFID can be useful in providing error free data transmission to system users. Since it does not require line of site scanning, shared data can be accessed or edited automatically. Likewise RFID can provide a number of benefits to the healthcare industry. Hospitals can incorporate an RFID system into their hospitals to eliminate manual entry of patient information and prescription and drug administration data. INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 4
Using an RFID system could additionally restrict unauthorized healthcare staff from accessing medical records, and prevent the misplacing or theft of medical equipment. RFID could further help to maintain a permanent record of hospital tool inventory, patient and staff whereabouts, real-time updated patient information, and detailed prescription information (i.e. expiration date, amount of prescription). The system could be useful for diagnosing conditions, initiating an automated charge capturing process, and routing medications directly to the pharmacy without having anyone to manage all of these tasks themselves. The most important element the RFID system could provide to a health care system would be in reducing medical errors due to adverse drug reaction by ensuring the patients’ five rights: Verifying that the right patient is being treated, the patient is given the right drug, at the right dose, and is given the right route to recovery at the right time. The following paragraphs describe some different types of RFID applications for healthcare such as: medical error prevention, blood and plasma applications, pharmaceutical applications, tracking of medical waste and devices, and patient and healthcare provider identification. Medical Errors Prevention Each hospital has an existing Hospital Information System (HIS) that stores information in a database containing patient, staff, and equipment information, etc. By incorporating RFID into a hospital, error reduction can be achieved in the following areas: medication administration, medical diagnosis, and misplaced medical devices. RFID System, El Camino Hospital El Camino Hospital in Mountain View, California has established a state of the art healthcare system by using RFID. The system allows the hospital to uniformly track medications, which are scanned and bar coded at the point of care. As a result of establishing the system, the hospital claims to have one of the lowest error rates in the nation. Since establishing the system it has increased its rate of clinical interventions-the number of times a pharmacist has the opportunity to intervene in the drug-ordering process to prevent errors-by 250%, growing from 400 interventions per quarter to 1,200. A 1998 study showed that the system helped to reduce medication error rates by 55%. Amid using the RFID system, El Camino has automated their pharmacy system so that prescription verifications can be done in 15 minutes or less. Therefore reducing time and errors that could occur from manual verifications. According to the El Camino Hospital CIO Mark Zielazinski, “Reducing medical errors not only improves patient safety but also provides a huge benefit to the hospital. The average cost of an error can range from $4,000 to $12,000 per instance. If only 1% of our interventions stop an error, that can quickly add up to half a million dollars.” Blood and Plasma Applications Typical RFID system uses for blood and plasma applications include tracking and tracing blood transfusions with a donor using SmartBand and blood bag identifications (i.e. blood code, type, date taken, lab technologist). SmartBand, Georgetown University Hospital In March 2004, Georgetown University Hospital Blood Transfusion Service initiated a study to evaluate whether or not the use of RFID wristbands and blood labels are as reliable as the use of bar codes and blood labels when transfusing blood. The study focuses on how much time can be saved when nurses are transfusing blood, and also to see how much easier it may be INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 5
for nurses to use the RFID technology, SmartBand, which was developed by Precision Dynamics Corporation. “We believe that the study will show that RFID is as reliable as bar coding as means of providing the conventional “double check” for blood transfusions” Dr. S. Gerald Sandler Director of Transfusion Medicine at Georgetown University Hospital stated. “We believe the findings will also show RFID technology to be more efficient and easier to use from a caregiver’s stand point compared to bar codes.” For more information on SmartBand technology, please visit the website: http://www.pdcorp.com/rfid/ Pharmaceutical Applications RFID applications for pharmacies include tracking counterfeit medicines, augmenting a medicine supply or medicine cabinet (by Accenture, Intel Research Seattle), storing prescription information that is tagged with Electronic Product Code (EPC), and automating medicine distribution. IV Medication Safety System In June of 2004, Alaris Medical Systems released a wireless RFID system called the IV Medication Safety System. This system has undergone testing in the Adventist Medical Center in Portland, the Hospital of the University of Pennsylvania, and Sharp HealthCare of San Diego. The purpose of the system is to eliminate the need to manually transfer information to and from medication systems. With the use of this system, medicine information can now be gathered automatically, without the need to touch each device. With the aid of this technology, the medicine distribution process is accelerated and errors related to medicine distribution are decreased. According to Nancy Pratt, MSN, RN, senior vice president, of Clinical Effectiveness at Sharp HealthCare of San Diego, indicated that the hospital shifted its technology priorities, allocating monies originally earmarked for bar-code medication administration (BCMA) to the Medley™ Medication Safety System with the Guardrails® Safety Software. "Patient safety is a strategic priority of our organization, and we knew we would see an immediate benefit from the Medley™ Medication Safety System," she said. For more information on IV Medication System, please visit the website: http://www.alarismed.com/ Tracking Medical Waste and Medical Devices Kureha Environmental Engineering Co. Ltd., a leading waste management company, will begin testing RFID tags to ensure that medical waste reaches its proper disposal point using medical tracking devices. A few of these device-tracking tools are DataLabel RFID tags, by Innovision Research & Technology, and Radianse ID tags (Radianse IPS). With the Radianse IPS device, RFID tags are placed on or inside of tools or objects to prevent tool misplacement. AgileTrac, Bon Secours Hospital According to TMCnet, in April 2004 Agility Healthcare Solutions provided tracking and management services for critical mobile medical equipment for three Bon Secours Richmond hospitals under a five-year service fee arrangement. The Agility system keeps track of hospital inventory and management applications. The system provides an analysis if there is a reduction in the amount of equipment required at the hospital and if there is an increase in productivity of hospital staff. AgileTrac, Agility's comprehensive mobile medical equipment management program, should have been fully operational this past spring, said Fran Dirksmeier, Agility chief executive officer. According to the RFID Journal, the system should show whether each tracked item is in use, available or in need of servicing. In the three Bon Secours hospitals, around 10,000 pieces of healthcare equipment will be logged in to Agility’s inventory management system and fitted with Agility’s active 303 MHz RFID tags. Jerrold Maki, Bon Secours Richmond's INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 6
chief administrative officer, said, “Agility has been able to quantify our total mobile equipment costs and streamline our equipment management processes.” In the future Agility plans to offer systems that provide asset management, reducing operation costs, and quality of care improvements. For more information on AgileTrac, please visit the website: www.trenstar.com/agility/ iRIS, Massachusetts General Hospital In May 2002 Massachusetts General Hospital installed its first trial of the iRIS RFID system, which was developed by Mobile Aspects. The purpose iRIS is to manage inventory and access to medical supplies and surgical parts throughout the hospital. By the end of 2002, Massachusetts General Hospital had installed six iRIS units in its operating rooms. According to the RFID Journal, with the assistance of iRIS over $500,000 worth of equipment and supplies were tracked. Additionally, iRIS has been integrated into the hospital’s scheduling and billing system. As a result of the success of iRIS at the Massachusetts General Hospital, similar systems have been installed at the hospital of the University of Pennsylvania, the University of Pittsburgh Medical Center and the Carolinas Medical Center. For more information on the iRIS Technology, please visit the website: http://www.mobileaspects.com/products/irissystem.html UWB Tags, Washington Hospital Center In April 2004 Washington Hospital Center in Washington D.C. began a trial use of RFID tags focusing on RFID usage in hallways and in emergency rooms. Washington Hospital is using active UWB or ultra-wide band tags, developed by Parco Wireless, to track medical devices in the hospital. Washington Hospital Center has the staff and patients wear credit card sized RFID tags to obtain and maintain patient and healthcare provider information. For more information on Parco Technologies, please visit their web site: http://www.parcomergedmedia.com Equipment Tagging, Vanderbilt Children's Hospital In Nashville, Tennessee the Vanderbilt Children's Hospital’s ICU had a history for missing equipment and unacceptable medical error rates. To solve this dilemma, the hospital piloted a six-month study using RFID technology. The RFID system was used for real-time tracking and location identification of moveable and fixed assets, and detection, identification and tracking of assets as they are utilized throughout the hospital. "Hospital equipment gets moved around a lot, and people lose track of where it is," says Jim Shmerling, executive director and CEO of Vanderbilt Children's Hospital. "We spent a lot of time and money looking for that equipment." After participating in this study using RFID, Vanderbilt Children’s Hospital was able to show that RFID systems can prevent the loss of equipment. According to Jim Shmerling, executive director and CEO of Vanderbilt Children's Hospital, the pilot was so successful he hopes to have a system in place at both Children's Hospital and Vanderbilt University Hospital by the end of this year. Patient and Healthcare Provider Information A priority for hospitals is to provide the most accurate Positive Patient Identification (PPI). RFID systems improve PPI by helping to ensure Patient Identification (PPI). RFID systems ensure PPI by helping to properly identify patients, which helps to reduce medical errors and saves hospitals money. A product that helps to ensure PPI is eShepard by Exavera, which uses patient and healthcare provider tracking using PDAs and Wi-Fi devices. There is also a RFID Wristband that obtains hospital admission information, retains patient information, and can track hospital staff or a patient’s whereabouts while on the hospital premises. INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 7
Tablet PC, El Camino Hospital El Camino Hospital has used their RFID system to obtain patient information. Physicians can enter patient and pharmacy information on Pocket PC–based handheld devices, other hospital computers, or Hewlett Packard Tablet PCs. These devices make prescription orders immediately visible to the pharmacy, where they are put through clinical checks for drug allergies and interactions. El Camino already bar codes its patient wristbands and is now testing medication scanning. El Camino will pilot bedside scanning this year and hopes to fully implement the technology in 2005. For more information on Hewlett-Packard PCs, please visit their website: http://welcome.hp.com/country/us/en/prodserv/notebooks_tabletpcs.html One more use of RFID for patient identification is to provide bedside scanning to gather information about a patient and their medicines from across the room. The basis for this technology is similar to that which is used to scan automobile passes at tollbooths. Bedside Scanning, Veterans Administration Hospital In March 2003, Veterans Administration Hospital installed a system that includes bedside scanning of pharmaceuticals and patient wristbands using equipment developed by Zebra Technologies and Symbol Technologies. “In addition to matching the right drug with the right patient at the right dosage, such systems can even ensure that the caregiver is authorized to dispense the drug, and they can provide better documentation for insurance reimbursement,” says Kenneth Kleinberg, senior director at Symbol Technologies. For more information on Symbol Technologies, visit their website: http://www.symbol.com/products/rfid/rfid.html An added form of RFID technology patient identification is in the use of under skin identification methods. Under skin identification methods can be useful in gathering patient information or for body identification. There is a technology called VeriChip that is a sub dermal RFID device that can be used in a variety of security, financial, emergency identification and other applications. It can give authorized healthcare officials access to medical records. As recent as October of this year, the United States Food and Drug Administration (FDA) approved the use of VeriChip to pass patient medical details to doctors, therefore speeding care. Already in Mexico, more than 1,000 VeriChips have been implanted in patients and have also been implanted in 200 people working in Mexico’s attorney generals office. The chip's serial number pulls up the patients' blood type and other medical information. VeriChip, Instituto Nazionale Lazzaro Spallanzani Hospital In April 2004 Instituto Nazionale Lazzaro Spallanzani Hospital in Rome, Italy initiated a six-month study of the VeriChip, healthcare application, VeriMed to observe patients whose medical conditions require vital information to be relayed to the hospital staff on a regular basis. The VeriMed technology will retain patients’ personal information and medical history. Once that information is obtained, the patient will endure a painless, two-minute procedure to place the chip in the triceps area between the elbow and the shoulder of the right arm. Once the chip is installed the patient’s information is scanned and retained into a hospital database. For more information on VeriMed, visit the website at: http://www.adsx.com/prodservpart/verichip.html A product by Microfour, called Practice Studio, tracks a data set for medical doctors to include in growth charts to track and report standardized information for pediatric child development. There is a Mobile Asset Management Program that specializes in reducing costs of equipment ownership (by Agility Healthcare Solutions). INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 8
For infants there is a technology by Georgia Tech called Augmented Child Behavior Observation System (CBOS) that observes children with Autism using RFID chips. RFID technologies are being incorporated into enabling home care for the elderly, which involves embedding RFID chips into personal items (i.e. toothbrushes, medications, toilet seats) to track an elderly person’s whereabouts and activities. Another RFID technology for the elderly is ADL Monitoring (Activities of Daily Living) (by University of Washington, Intel Research Seattle) that has an RFID glove to track activities or items touched. In addition, RFID tags can be scattered around a home to detect home activities. A product called Smart Bed can monitor a person’s movements and weight and relies on a network of embedded cameras and temperature sensors to make inferences about behavior. Summary RFID technology can provide a variety of benefits for healthcare. There are a number of ongoing trials and studies at hospitals and healthcare centers around the world utilizing and integrating RFID into their hospital information systems. Because of RFID studies and trials, it has been found that RFID elicits improvements in inventory management, patient safety, and security. Some hospitals have found that through RFID systems medical errors have been reduced, which results in a reduction in costs to run medical programs. Positive Patient Identification can be achieved through the use of an RFID system. This is an essential policy for a hospital since the leading cause of death due to medical errors is caused by patient misidentification, and specimen or medication misidentification. These errors result in billions of dollars in national costs per year. Reducing medical errors not only increases patient safety, but also provides a huge benefit to a hospital. When choosing RFID tag types or an RFID system, work with a consultant, integrator or vendor that can help you choose the right frequency and tag type for your application. The new Healthcare-IT Czar, Dr. David Brailer, and Health and Human Services Secretary, Tommy Thompson, endorse RFID as one of the technologies the healthcare market should look to implement to promote patient safety and optimize hospital workflow. Each type of RFID system can be tailored to fit the needs of all healthcare programs. Every hospital is encouraged to integrate their existing system with RFID in order to reap the benefits of the evolution of healthcare technology’s marvel, RFID. INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 9
Appendix A- RFID Vendor Product Information Overview Vendor Product Description Agility Healthcare AgileTrac AgileTrac is a comprehensive mobile medical equipment management program. AgileTrac will keep track of the location and quantity of each piece of Solutions medical equipment. Alaris Medical Medley It is a wireless connectivity application for the company’s Medley Medication Safety System. It includes coverage for all infusions on one platform, PCA Systems Medication IV (Patient-Controlled Analgesia), large volume delivery, patient monitoring and syringe delivery. It is a module for the administration of pain management Safety System drugs through the Smart IV Medication Safety System. Applied Digital VeriChip, VeriChip is a secure, sub-dermal, RFID microchip about the size of a grain of rice that can be used in a variety of security, financial, emergency Solutions VeriMed identification and other applications. Extravera eShepard eShepard is a technology to use patient and healthcare tracking via PDAs and Wi-Fi devices. Georgia Tech ACBOS The Augmented Child Behavior Observation System observes children with Autism using RFID chips. Hewlett-Packard RFID Starter HP is producing tablet PCs to expedite drug verification processes and obtaining or maintaining patient information. Kit IBM RFID Tags IBM has developed a product to help track medical waste as it leaves hospitals. IBM and Japan’s RFID Solution Center in Yamato, Japan will participate in trials to make sure medical waste is being deposited in a proper location in a timely manner. Intel iGlove, iGlove is a glove mounted with an RFID reader that is used to track daily activities of an individual that needs to be monitored at home for health reasons. ADL iGlove uses a system that understands and interprets daily activities through auto-identification and statistics. The system guesses what a person is doing Monitoring based on how a person interacts with objects around them. Activities of Daily Living(ADL) monitors people that require in home care via the iGlove. Innovision Research DataLabel DataLabel is a medical tracking device where RFID tags are placed inside or on devices to keep track of the whereabouts, inventory, and use of the devices. Microfour Practice Studio Practice Studio compiles a data set for medical doctors to include in growth charts that track and report standardized information for pediatric child development. MobiHealth RFID /m-Health MobiHealth is producing a positive patient identification on a handheld device with RFID technology. Their system helps hospitals and physicians reduce Suite errors throughout the medication management process. Mobile Aspects IRIS The Intelligent Radio-Frequency Inventory System (iRIS) is supposed to replace the labor-intensive systems that hospitals currently use to catalog products and replenish essential medical supplies and surgical parts such as pacemakers and replacement joints. iRIS can also help ensure that items are used in a timely fashion. Parco Wireless UWB RFID The ultra-wideband (UWB) RFID system for healthcare facilities will have tags attached to medical equipment to track those devices. It will also keep track tags of patient and hospital staff information and their whereabouts via credit card sized RFID tags. Precision Dynamics Smart Bands The Smart Band RFID Wristband System acts as a portable, dynamic database that carries information to be used and updated during the patient's stay. With Corporation nearly 50 years of experience, PDC is the global leader and pacesetter in the development of automatic identification wristband systems and quality healthcare products. The company introduced the first patient bar code wristband in 1984 and radio frequency identification (RFID) wristbands in 2000. Radianse Radianse IPS Radianse ID-tag (IPS) helps to track medical devices within the hospital or within an object. RSA Security Blocker Tags Blocker tags disrupt the transmission of information to scanning devices and prevent illegal collection of data. Siemens Business RFID Chips/ RFID wristbands technology is able to track patients by incorporating RFID chips into the plastic band strapped onto patients' wrists during hospital Services Tags admissions. Symbol Bedside Bedside scanning and wristbands enable a caregiver to obtain patient information from across a room. Technologies, Zebra Scanning, Technologies Wristbands INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 10
Appendix B- Glossary Bottleneck – A bottleneck can be referred to a clog in a flow path. Code of Fair Information Practices – It is a set of rules that apply to RFID system users and anyone how has any information tracked using the system: (1) There must be no personal data record-keeping systems that are covert. (2) There must be a way for a person to find out what information about the person is in a record and how it is used. (3) There must be a way for a person to prevent information about the person that was obtained for one purpose is being used or made available for other purposes without the person’s consent. (4) There must be a way for a person to amend or correct a record of identifiable information about the person. (5) Any organization creating, using, maintaining, or disseminating records of identifiable personal data must assure the reliability of the data for their intended use and must take precautions to prevent misuses of the data. Electronic Product Code (EPC) - Similar to a bar code, it is a numbering scheme used to identify products as they move through the global supply chain. Food and Drug Administration (FDA) – The Food and Drub Administration enforces laws pertaining to health, food, drug, and other issues. Health Insurance Portability and Accountability Act of 1996 (HIPAA) - The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) require the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data. Adopting these standards will improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in health care. Hospital Information System (HIS) - HIS is a system used by a healthcare facility to store patient information, staff information, prescription information, scheduling, billing, etc. Intelligent Radio-Frequency Inventory System (iRIS) System – RFID based system to manage the data collection, and to automate the tracking, billing and ordering of these surgical items and link the system with a hospital's information system. Intensive Care Unit (ICU) – The ICU is a special department of a hospital that cares for patients that need more intensive care than other patients. International Organization for Standardization (ISO) – A network of national standards institutes from 146 countries working in partnership with international organizations, governments, industry, business, and consumer representatives. Indoor Positioning System (IPS) – IPS is an indoor positioning system that delivers the affordability and simplicity necessary to make location technology pervasive in the healthcare environment. Joint Commission on Accreditation of Health Care Organizations (JCAHO) – JCAHO provides information to health care organizations about how to become an accredited JCAHO facility. JCAHO provides information on standards, survey process, ORYX, sentinels and other information for accreditation. Kilohertz (kHz) - Used as an indicator of the frequency for low frequencies. Megahertz (MHz) – Used as an indicator of the frequency for high and ultra-high frequencies. Medley Medication Safety System - ALARIS Medical Systems is the only provider of harm-prevention software in a modular medication safety system. The company's proprietary Medley(TM) System offers INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 11
coverage for all infusions on one platform and includes PCA, large volume delivery, patient monitoring and syringe delivery. Patient-Controlled Analgesia (PCA) – PCA is a pain-control system where a patient can treat his own pain rather than wait for a nurse to give more medication. PCA uses a computerized pump hooked up to a patient's IV. Personal Digital Assistant (PDA) – A PDA is a portable device used to store various types of information. The information stored depends on the type of PDA. Relational Check Code (RCC) – RCC is a method or a permanent code that is burned in with a specific identification code (on a barcode, RFID tag code) along with a writable code portion. Time Division Multiple Access (TDMA) - is a mechanism for sharing a channel, whereby a number of users have access to the whole channel bandwidth for a small period of time (a time slot). Ultra-Wide Band Tags (UWB) – Ultra-wide band tags are used to transmits short-duration radio waves that are finished before they can reflect off walls and ceilings, thus eliminating the opportunity for cancellation. Wi-Fi devices – A type of wireless device that enables wireless network access. INFOHEALTH Management Corp. One IBM Plaza, Suite 2917, Chicago, IL 60611 (312) 321-1638 www.infohealth.net © October 2004 Page: 12
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